Synovial biopsy was done coaxially following aspiration using a 22-gauge Chiba needle or 21-gauge Sure-Cut needle. Standard microbiological analysis was performed on preoperative synovial fluid aspirate and synovial biopsy. Intraoperative tissue biopsy bacteriological analysis results at surgical revision were accepted as the “”gold standard”" for the presence or absence of infection.

Seventeen of 110 (15 %) of patients had intraoperative culture-positive periprosthetic infection.

Of these 17 cases, there were ten cases where either the synovial fluid aspiration and/or the synovial biopsy were true positive (sensitivity of 59 %, specificity of 100 %, positive predictive value of 100 % and accuracy of 94 %). There were Epigenetic inhibitor seven cases where aspiration and biopsy results were both falsely negative, but no false-positive results. Similar results were found for

synovial fluid aspiration alone. The results of synovial biopsy alone Epigenetics inhibitor resulted in the identification of seven infected joints with no false-positive result (sensitivity of 41 %, specificity of 100 %, positive predictive value of 100 %, and accuracy of 91 %).

Standard microbiological analyses performed on percutaneous synovial biopsy specimen during the preoperative evaluation of patients undergoing revision hip arthroplasty did not improve detection of culture-positive periprosthetic infection as compared to synovial fluid aspiration alone.”
“Resistant hypertension is currently defined as the failure to achieve a goal blood pressure <140/90 mmHg in patients who are compliant with maximal tolerated doses of a minimum of three antihypertensive drugs, one of which must be a diuretic. The increasing prevalence of obesity and hypertension in the general population mean that this disorder has gained attention in the past decade. In the past 2 years, large-scale

population-based studies such as the US National Health and Nutrition Examination Survey (NHANES) have specifically examined the prevalence and incidence of resistant hypertension, and associated risk factors. CCI-779 The findings suggest the prevalence of resistant hypertension is 8-12% of adult patients with hypertension (6-9 million people). The increasing prevalence of resistant hypertension contrasts with the improvement in blood pressure control rates during the same period. Studies also show that patients with resistant hypertension aged >55 years, of black ethnicity, with high BMI, diabetes or chronic kidney disease have an increased risk of cardiovascular events compared to nonresistant hypertensive patients. Analyses that exclude the effects of white-coat hypertension and pseudoresistant hypertension are also needed to clarify the epidemiology of true resistant hypertension. Sarafidis, P. A. et al. Nat. Rev. Nephrol. 9, 51-58 (2013); published online 20 November 2012; doi:10.1038/nrgastro.2012.